Evidence map›Paper›PMID 29428434›Full record

ArticleJACC. Heart failure2018

Impact of Body Mass Index on Heart Failure by Race/Ethnicity From the Get With The Guidelines-Heart Failure (GWTG-HF) Registry.

Tiffany M Powell-Wiley, Julius Ngwa, Selomie Kebede, Di Lu, Phillip J Schulte, Deepak L Bhatt, Clyde Yancy, Gregg C Fonarow, Michelle A Albert

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 1 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Maintained sympathetic reactivity but blunted pressor response to static handgrip exercise in heart failure with preserved ejection fraction.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025
    Article
  7. Review
  8. Article
  9. Article
  10. Global epidemiology of heart failure.Nature reviews. Cardiology · 2024
    Review
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Therapeutic Stalemate in Heart Failure With Preserved Ejection Fraction.Journal of the American Heart Association · 2021
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 8 institutions in 1 country.

Tiffany M Powell-WileyCardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: tiffany.powell-wiley@nih.gov.
Julius NgwaDivision of Cardiovascular Medicine, Howard University Hospital and School of Medicine, Washington, DC.
Selomie KebedeDivision of Cardiovascular Medicine, Howard University Hospital and School of Medicine, Washington, DC.
Di LuDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
Phillip J SchulteDepartment of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Deepak L BhattHeart and Vascular Center, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Clyde YancyCardiovascular Division, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Gregg C FonarowRonald Reagan University of California at Los Angeles Medical Center, Los Angeles, California.
Michelle A AlbertCenter for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Cardiology Division, University of California at San Francisco Medical Center, San Francisco, California.
Howard University Hospital · USBrigham and Women's Hospital · USDuke University · USMayo Clinic in Florida · USNational Institutes of Health · USNorthwestern University · USUniversity of California, Los Angeles · USUniversity of California San Francisco Medical Center · US

Funding

Cardiovascular Health and Needs Assessment in Washington D.C.ZIAHL006168 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI POWELL-WILEY, TIFFANY · 2013 to 2025
$8.1M
Eye and Vision Genomics Training ProgramT32EY022303 · NEI · JOHNS HOPKINS UNIVERSITY · PI BEATY, TERRI H · 2013 to 2017
$799k
Intramural NIH HHS Z99 HL999999NEI NIH HHS T32 EY022303
6 · The paper itself

Abstract

objectivesThis study sought to evaluate the influence of race/ethnicity on the relationship between body mass index (BMI) and mortality in heart failure with preserved ejection fraction (HFpEF) and HF with reduced EF (HFrEF) patients.

backgroundPrior studies demonstrated an "obesity paradox" among overweight and obese patients, where they have a better HF prognosis than normal weight patients. Less is known about the relationship between BMI and mortality among diverse patients with HF, particularly given disparities in obesity and HF prevalence.

methodsThe authors used Get With The Guidelines-Heart Failure data to assess the relationship between BMI and in-hospital mortality by using logistic regression modeling. The authors assessed 30-day and 1-year rates of all-cause mortality following discharge by using Cox regression modeling.

resultsA total of 39,647 patients with HF were included (32,434 [81.8%] white subjects; 3,809 [9.6%] black subjects; 1,928 [4.9%] Hispanic subjects; 544 [1.4%] Asian subjects; and 932 [2.3%] other subjects); 59.7% of subjects had HFpEF, and 30.7% were obese. More black and Hispanic patients had Class I or higher obesity (BMI ≥30 kg/m

conclusionsThis work is one of the first suggesting the obesity paradox for 30-day mortality exists at all BMI levels in HFrEF but not in patients with HFpEF. Higher BMI was associated with lower 30-day mortality across racial/ethnic groups in a manner inconsistent with the J-shaped relationship noted for coronary artery disease. The differential slope of obesity and mortality among HFpEF and patients with HFrEF potentially suggests differing mechanistic factors, requiring further exploration.

Indexed as

AgedAged, 80 and overAsianBlack or African AmericanBody Mass IndexCohort StudiesEthnicityFemaleHeart FailureHispanic or LatinoHumansMaleObesityOverweightRacial GroupsRegistriesethnicityGWTG-Heart Failureheart failuremortalityobesityrace

Identifiers

PMID29428434
PMCPMC5834392
OpenAlexW2789393054

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.